As Republicans consider how to bring down costs for younger people, lawmakers may relax or eliminate the restrictions on how much more insurers can charge older consumers. (Jordan Rau and Julie Appleby,
2/22)

Some foreign-born California residents fear they could be penalized for using Medi-Cal and other social benefits. Others, in families of mixed-immigration status, worry about jeopardizing their loved ones’ chances of becoming green-card holders or citizens. (Emily Bazar,
2/22)

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Summaries Of The News:

“With all due respect, sir, you’re the man that talked about the death panels. We’re going to create one great big death panel in this country,” the vice chairman of the Iowa Democratic Party’s Rural Caucus said at Sen. Chuck Grassley's town hall meeting. Across the country, lawmakers are facing agitated and concerned voters during their weeklong recess.

The New York Times:
At Town Halls, Doses Of Fury And A Bottle Of Tums
Representative Marsha Blackburn may have expected to draw a friendly crowd by scheduling a town hall-style meeting in a Tennessee community that had voted overwhelmingly for President Trump, but she instead faced a hurricane-strength blast of disapproval on Tuesday. Ms. Blackburn, an eight-term Republican, was sharply questioned about a wide range of issues that have unsettled Mr. Trump’s first month in office, including health care, the environment, education and the president’s links to Russia. (Gabriel, Kaplan, Alvarez and Huetteman, 2/21)

The Associated Press:
GOP Members Of Congress Meet With Protests At Town Halls
A month into Trump's presidency, protests continue over his immigration policies, Cabinet selections and the GOP's push to repeal the Affordable Care Act, without all the specifics on how to replace it. At the town halls, protesters are probing their lawmakers to see if they will veer from some of Trump's more controversial decisions, and if they will promise coverage for those currently served by the Affordable Care Act. Trump took to Twitter on Tuesday to address the town halls. "The so-called angry crowds in home districts of some Republicans are actually, in numerous cases, planned out by liberal activists. Sad!" he tweeted. (Matisse, 2/21)

The Associated Press:
US Senate Leader: Winners Make Policy, Losers Go Home
Nearly 1,000 people jeered Senate Majority Leader Mitch McConnell as he drove to a speech Tuesday where he told local business leaders that "winners make policy and the losers go home." ... Several people stood and booed as McConnell finished his remarks, including answering a few questions about the Affordable Care Act and regulations on the financial industry imposed by the legislation known as Dodd-Frank. McConnell was largely unfazed by those he called "the people outside," saying he was "proud" of them for expressing their views. (Beam, 2/21)

Politico:
This Time, Grassley Hears Pro-Obamacare Voices
What a difference eight years makes. More than 100 Iowans on Tuesday packed into a small farm town community center by 7:45 a.m. to urge Sen. Chuck Grassley not to repeal Obamacare, and to air their opposition to President Donald Trump’s agenda, his Cabinet nominees and his Supreme Court pick. (Haberkorn, 2/21)

Politico:
GOP Lessons From The Latest Round Of Brutal Town Halls
An overflow crowd here was eager to take on Rep. Dave Brat, the conservative Republican who just weeks earlier needled liberal protesters in his district and groused about all the women “in my grill” over GOP plans to repeal and replace Obamacare. But with a plain-spoken approach — and a format that didn't revolve around live-fire questions from the combative crowd — Brat offered his colleagues a potential blueprint for defusing tense constituent town halls that have bedeviled his Republican colleagues as they’ve been swarmed by protesters. (Cheney, 2/21)

CNN:
Brat Faces Raucous Crowd At Town Hall
Rep. Dave Brat faced a raucous crowd Tuesday night at a town hall here in the outer edge of his district, where a majority of the room interrupted him with angry shouts and jeers. The Virginia Republican took at least 34 questions for over an hour and at times appeared to enjoy the back-and-forth. "I don't mind boisterousness. I'm having fun," Brat said toward the end, swinging his arm in the air as people continued to shout at him. "I like having debate, spirited conversation -- if you can have a conversation." (Killough, 2/21)

WAVY (Hampton Roads, Va.):
Boisterous Crowd Voices Concerns At Rep. Taylor’s First Town Hall In Va. Beach
Representative Scott Taylor (R-VA) held a packed town hall meeting at Kempsville High School in Virginia Beach Monday night. 10 On Your Side’s Joe Fisher reports the crowd was at capacity with about 750 people inside. Hundreds more were turned away at the door because they couldn’t fit in the school’s auditorium. ... Taylor also said he supports the repeal of the Affordable Care Act and the implementation of a new policy that doesn’t discriminate against people with pre-existing conditions. “The vast majority of people are getting crushed by Obamacare,” he said. “What’s responsible I believe, is dissecting, having a discussion, and finding the best thing.” (Satchell, 2/21)

KTVH (Helena, Mont.):
Hundreds Gather In Helena To Ask Daines To Hold Town Hall
U.S. Sen. Steve Daines was scheduled to speak before the Montana House Tuesday, but several hours before the address, his office announced it had been rescheduled to Wednesday. Despite that change, hundreds of protesters still gathered on the State Capitol steps in Helena in hopes of getting the senator’s attention. ... Celeste Thompson, a home care worker, said she has health care because of the federal Affordable Care Act. She asked for more information on how Republicans in Congress plan to replace the ACA if it is repealed. “Our lives and so many others depend on access to health care,” Thompson said. “If the Affordable Care Act is repealed, that access will be stripped away from us.” (Ambarian, 2/21)

Montana Public Radio:
Protesters Give Sen Daines An Earful At The State Capitol
Just before U.S. Senator Steve Daines was scheduled to give a speech in front of Montana lawmakers Tuesday afternoon, a crowd of protesters gathered on the Capitol steps. The event was organized by a Facebook group called "Bring The Town Hall to Steve Daines". ... About an hour and a half before Senator Daines was scheduled to arrive at the Capitol Tuesday to address Montana's House of Representatives, he postponed his speech, pushing it to Wednesday. Staff with Senator Daines' office say he pushed his speech back a day to work with his schedule, saying Daines had several other reasons to be in Helena on Wednesday. (Cates-Carney, 2/21)

Arkansas Online:
Cotton Hears Medicare Concerns
A group of Arkansas senior citizens told U.S. Sen. Tom Cotton on Tuesday that they like their Medicare Advantage plans, but a few expressed concerns about higher spending caps and rising medication costs. Cotton, a Republican from Dardanelle, told the group that he supports the federally-funded program and will defend it on Capitol Hill. Nonetheless, the overall health care system needs changes, he said, promising to work to improve it. (Lockwood, 2/22)

CQ Roll Call:
Health Coverage Questions Persist For Republicans
As Republican lawmakers face questions from constituents and colleagues about their plans to repeal and replace the 2010 health care law, they're finding few answers, including what kind of legislation could pass the Senate. Republicans do not need Democratic support to undo parts of the law, since they will move the legislation through the budget reconciliation process that requires a simple majority in the Senate. But with only 52 Republican senators, the GOP plan will need support from the party's conservatives and moderates, and it’s not clear what could get everyone on board. (Bowman, 2/22)

In addition to a credit to help people buy insurance, Republicans have suggested opening up some employer-sponsored health insurance plans to taxation. Both ideas are drawing opposition from the right wing of the party. Meanwhile, the fight over Medicaid looms large in the Senate.

The Hill:
Two Tax Issues Dividing Republicans On ObamaCare
Republican lawmakers are objecting to two key elements of their party's plan to replace ObamaCare, creating obstacles in the road to repeal. Conservatives worry a tax credit to assist people with the cost of insurance, which would help people maintain or get coverage, will be too costly and that recipients might abuse the government help...Objections also are being raised against a proposal to open up some employer-sponsored health insurance plans to taxation. Some Republicans worry that proposal is essentially a new version of ObamaCare’s much-reviled “Cadillac tax." (Sullivan, 2/21)

The Hill:
­ObamaCare Fix Hinges On Medicaid Clash In Senate
The most divisive issue for Senate Republicans when it comes to repealing and replacing ­ObamaCare is what to do with Medicaid. The Affordable Care Act gave states the option of accepting federal funds to expand Medicaid, the healthcare program for the poor and disabled. Millions of people gained health insurance after 31 states — including many with Republican governors — decided to accept the deal. Repealing ­­ObamaCare would end the Medicaid expansion, cutting federal funds to all of those states. (Bolton, 2/22)

Iowa Public Radio:
Loebsack: GOP Plan To Replace ACA "Wholly Inadequate"
Iowa’s only Democrat in the U.S. House of Representatives says he still doesn’t know the details of what Republicans will propose as a replacement for the Affordable Care Act. Dave Loebsack is on the House Energy and Commerce Committee, which will vote on a replacement before sending it to the full House. (Kieffer, Perkins and Leland, 2/21)

House Republicans had filed the suit in response to a series of President Barack Obama’s unilateral executive actions on paying insurers that they said were unconstitutional.

The Wall Street Journal:
Trump Administration Seeks Delay In Lawsuit Over Health-Law Subsidies
The Trump administration and House Republicans on Tuesday asked a court for a further delay in a lawsuit over certain Affordable Care Act subsidies, a move that may help assuage insurers debating whether to participate in the health law’s 2018 exchanges. In May, a federal district court judge ruled that the government was improperly reimbursing insurers to help them cover discounts they were required to give some low-income consumers, potentially a major blow to the insurers. (Hackman, 2/21)

CQ Roll Call:
Trump, House GOP Seek Delay In Key Obamacare Lawsuit
An end to the lawsuit could mean an end to the subsidy payments, so lawmakers would be prompted to act if they want to keep the insurance market stable while they come up with legislation. Insurers have called the payments "critical," and made the issue their chief lobbying priority. Top Republicans, including appropriators, now say they’re willing to make the payments as they implement a health policy overhaul, despite a previous unwillingness to do so under the Obama administration that sparked the lawsuit in the first place. (Ruger, 2/21)

Morning Consult:
House, DOJ Seek To Continue Hold In Case Over Obamacare Payments
Now lawyers for the House of Representatives and the Department of Justice want the case to remain on hold, meaning insurers would still receive payments in the meantime. Both sides proposed keeping the case on hold and giving status reports every three months, beginning May 22, 2017, according to a joint motion. “The House and Department of Justice filed a motion seeking more time to continue efforts to resolve the lawsuit without the court’s assistance,” Doug Andres, a spokesman for House Speaker Paul Ryan, said in an email. (McIntire, 2/21)

In other news —

Modern Healthcare:
Filing Extension May Not Be Enough To Keep Insurers In Individual Market
Health insurers are pleased the Trump administration wants to give them seven extra weeks to file rates for individual-market plans in 2018. But that move does little to settle their uncertainty about whether to offer plans at all. Their anxiety has been heightened by the Republican drive to repeal and replace the Affordable Care Act and by a pending House Republican lawsuit to block certain payments to insurers. Carriers say they need to know the rules of any new system before they can design plans and set rates. (Dickson, 2/21)

For those who were able to get federal subsidies, the health law was a blessing. The ones who didn't were left feeling angry and short-changed.

The Associated Press:
Health Law Created Winners And Losers When Buying Insurance
Michael Schwarz is a self-employed business owner who buys his own health insurance. Subsidized coverage through "Obamacare" offers protection from life's unpredictable changes and freedom to pursue his vocation, he says. Brett Dorsch is also self-employed and buys his own health insurance. But he gets no financial break from the Affordable Care Act. "To me, it's just been a big lie," Dorsch says, forcing him to pay more for less coverage. (Alonso-Zaldivar, 2/22)

Kaiser Health News:
GOP Fix To Insurance Markets Could Spike Premiums For Older Customers
Dale Marsh has not been enamored with his health insurance since the Affordable Care Act took effect. Premiums for Marsh, 53, and his wife, Tammy, rose, their deductibles grew, and they gave up access to their regular doctors to keep costs down. This year, facing monthly premiums of $1,131 — a 47 percent increase from four years before — they decided to go without coverage. “It’s useless insurance,” said Marsh, who owns a software company with Tammy, 52, in Graford, Texas. “We’re praying for the best, that neither one of us need insurance, that we don’t have to go the hospital." Yet, a new premium spike may be in store for those in their 50s and 60s. (Rau and Appleby, 2/22)

In other news, worries about repeal persist —

The Associated Press:
'It Saved My Life': Talk Of Obamacare Repeal Worries Addicts
While the Affordable Care Act has brought health coverage to millions of Americans, the effects have been profound, even lifesaving, for some of those caught up in the nation's opioid-addiction crisis. In Kentucky, which has been ravaged worse than almost any other state by fentanyl, heroin and other drugs, Tyler Witten went into rehab at Medicaid's expense after the state expanded the program under a provision of the act. Until then, he had been addicted to painkillers for more than a decade. "It saved my life," he said. (Beam and Johnson, 2/22)

The Philadelphia Inquirer:
Advocates: Repealing Obamacare Would Cost N.J. Jobs And Lives
The generally left-leaning groups detailed county-by-county effects in an effort to get residents to put pressure on representatives at town hall meetings during this week’s congressional recess. Some lawmakers who have not scheduled meetings are discovering that gatherings have been planned in their absence. With more than $4 billion a year in direct federal funding at stake, the ripple effect of rescinding the law would kill 86,000 jobs, according to an analysis by New Jersey Policy Perspective. About 800,000 residents would lose health insurance without the ACA's Medicaid expansion and subsidies for coverage purchased on the federal exchange. Plus, 212,000 seniors who fall into Medicare’s “doughnut hole” would each lose an average $1,241 in prescription assistance. (Sapatkin, 2/21)

Asbury Park Press:
Group: Obamacare Repeal Costs Jersey Shore Over $500M
The Jersey Shore would lose more than $500 million a year in federal funding and 11,000 jobs if Obamacare is repealed without a replacement, according to a study released by consumer advocates on Tuesday. While replacement proposals on the table would soften the blow, they would leave New Jersey and consumers with less financial help for health care and possibly insurance policies that don't cover as much, they said. (Diamond, 2/21)

Also, another look at what it means for a Medicare beneficiary to be "under observation."

Modern Healthcare:
Doctors, Payers May Dislike Changes To Primary-Care Model
A tweak in the way some providers are reimbursed under a new primary-care payment model could deter providers from joining the Medicare initiative. The CMS is looking to expand its ambitious primary-care model known as Comprehensive Primary Care Plus. But there hasn't been as much interest in the pilot as anticipated, and now the agency wants to pay incentives only to some participating providers and not others. (Dickson, 2/21)

The state has worked to clear up many other Medicaid backlogs, but applications for long-term care are often complicated and the decisions still lag, KCUR reports. Other outlets also report on Medicaid news in Minnesota and Colorado.

KCUR:
For One Family, Move To Kansas Meant Medicaid Delays
All that Michael Sykes has to show for his months-long quest to get his mother’s nursing home bed covered by Medicaid is a pile of paperwork. Kansans like Sykes have been facing long waits to find out if they qualify for health coverage under KanCare, the state’s privatized Medicaid program. The state has cleared up much of the backlog over the past year, but thousands of applications for long-term care coverage remain hung up. That has left applicants frustrated and forced nursing homes to absorb months of delayed payments. (Marso, 2/22)

KCUR:
What’s The Matter With KanCare? Challenges On Four Fronts
KanCare is a $3 billion program that provides health insurance to more than 425,000 Kansans — complex and bureaucratic by its nature. And lately it seems the privatized Medicaid program has drawn more than its share of complaints from Kansas medical providers, beneficiaries and applicants. Some are the result of a switch in 2013 to management not by the state but instead by three private insurance companies, while others stem from court rulings or policymaker decisions. (Marso, 2/22)

The (Minneapolis) Star Tribune:
Report Calls For Stronger Oversight Of Medicaid Spending For Disabled, Elderly
Minnesota does not collect adequate information to monitor programs that spend more than $2 billion annually on care and services for the elderly and people with disabilities, according to a legislative auditor report released Tuesday. ... However, the Minnesota Department of Human Services (DHS) does not provide adequate financial oversight of the organizations that provide the services, nor does it adequately regulate the workers who go into people's homes, the report said. (Serres, 2/21)

Colorado Public Radio:
Grand Junction Shows How To Lower Medicaid Costs While Improving Care
Medicaid provides health insurance for more than a million Coloradans, who comprise about a fifth of the state population. Medicaid is also one of the largest parts of the state budget, and costs rise each year. That spurred lawmakers to support an experiment by a health care collaborative in the Western Slope, Rocky Mountain Health Plans. ... Patrick Gordon, associate vice president at Rocky Mountain Health Plans, spoke to Colorado Matters host Ryan Warner. (2/21)

The federal judge said the state did not provide credible evidence that the organization violated medical or ethical standards related to abortion procedures.

Houston Chronicle:
Federal Judge Stops Texas From Kicking Planned Parenthood Out Of Medicaid
A federal judge on Tuesday stopped Texas officials from kicking Planned Parenthood out of the state's Medicaid program, providing a reprieve that will at least temporarily allow the organization to continue receiving reimbursements for providing non-abortion services to about 10,000 poor residents. U.S. District Judge Sam Sparks said in a 42-page ruling that he was not swayed by the state's explanation for the eviction - an undercover video that purported to show that Planned Parenthood was illegally selling the organs of aborted fetuses - and would not allow the move until and unless the state provides a better rationale at a full trial. (Rosenthal, 2/21)

The New York Times:
Judge Blocks Medicaid Cuts To Planned Parenthood In Texas
A federal judge on Tuesday temporarily blocked Texas from cutting off Medicaid funding to Planned Parenthood, ruling the state had presented no credible evidence to support claims the organization violated medical or ethical standards related to abortion procedures.The ruling, a preliminary injunction issued by Sam Sparks, a United States District Court judge in the Western District of Texas, means that, for now, 30 health centers that serve about 12,500 Medicaid patients can continue to receive funding from the medical program that serves the poor. The case is set to go to trial, where the judge can rule on its merits. (Mele, 2/21)

The Associated Press:
Judge Blocks Texas Cutting Medicaid To Planned Parenthood
An injunction issued by U.S. District Sam Sparks of Austin comes after he delayed making decision in January and essentially bought Planned Parenthood an extra month in the state’s Medicaid program. ... Sparks’ decision preserves what Planned Parenthood says are cancer screenings, birth control access and other health services for nearly 11,000 low-income women at 30 clinics. Texas originally intended to boot Planned Parenthood in January but Sparks told the state to wait pending his ruling. Arkansas, Alabama, Kansas, Mississippi and Louisiana have also had similar efforts blocked. (Weber, 2/21)

Dallas Morning News:
Federal Judge Blocks Texas' Move To Kick Planned Parenthood Out Of Medicaid
Texas Attorney General Ken Paxton said in a prepared statement that he will appeal the decision, which he said "is disappointing and flies in the face of basic human decency." "Even the remains of the most vicious criminals are treated with respect," Paxton said. "But the children who never had a chance at life become so-called medical waste or, alternatively, a commodity to be bartered for. No taxpayer in Texas should have to subsidize this repugnant and illegal conduct. We should never lose sight of the fact that, as long as abortion is legal in the United States, the potential for these types of horrors will continue." (Mekelburg, 2/21)

The Associated Press:
McAuliffe Vetoes Bill Cutting Abortion Clinics' Funding
Virginia Gov. Terry McAuliffe has vetoed a bill that would have restricted funding for Planned Parenthood clinics. The Democrat vetoed the measure Tuesday during an event outside the executive mansion. He vetoed the same measure last year and said Tuesday it would harm tens of thousands of Virginians who rely on Planned Parenthood. (2/21)

Richmond Times Dispatch:
McAuliffe Vetoes Bill That Would Defund Planned Parenthood
Gov. Terry McAuliffe has vetoed a bill that would restrict Planned Parenthood from contracting with the state. The bill, sponsored by Del. Benjamin L. Cline, R-Rockbridge, passed the Senate last week on a 20-19 vote. It would prevent the Virginia Department of Health from providing funds to clinics that provide abortion services to women who are not covered by Medicaid. (Demeria, 2/21)

And a new regulation gains traction in the anti-abortion movement, but scientific evidence for the procedure is lacking —

The Associated Press:
Experts: Science Behind 'Abortion Reversal' Is Flawed
Lawmakers in several states are considering requirements for doctors to inform women seeking medical abortions about an unproven procedure called "abortion reversal." Doctors' groups oppose the bills because of flawed science and ethical concerns. There is no evidence the procedure works and little information about its safety. The procedure involves shots of the hormone progesterone given if a woman changes her mind after the first step of a medical abortion. (Johnson, 2/22)

Many lawmakers across the country are motivated by the way their loved ones have been touched by the epidemic. "We're all here because we have this empty void in our lives," said Minnesota state Rep. Dave Baker, whose son started out taking prescription drugs for back pain and died of a heroin overdose in 2011. Media outlets report on the crisis out of New Hampshire, Massachusetts, Minnesota and Georgia.

The Associated Press:
State Lawmakers Channel Grief Into Fight Against Opioids
In statehouses across the country, lawmakers with loved ones who fell victim to drugs are leading the fight against the nation's deadly opioid-abuse crisis, drawing on tragic personal experience to attack the problem. A Minnesota state senator whose daughter died of a heroin overdose in a Burger King parking lot — a friend hid the needles instead of calling for help — spearheaded a law that grants immunity to 911 callers. In Wisconsin, a state representative has introduced more than a dozen opioid-related bills in the years since his daughter went from painkillers to heroin to prison. A Pennsylvania lawmaker whose son is a recovering heroin addict championed a state law that expanded availability of an antidote that can reverse an overdose. (Potter, 2/21)

New Hampshire Union Leader:
Ground Broken On Expanded Treatment Center In Manchester
City and state leaders marked a milestone in combating the opioid, heroin and fentanyl crisis with the ground-breaking Tuesday of an expanded treatment center and new recovery housing. The Families in Transition’s Family Willows Substance Use Treatment Center and Recovery Housing, located in the old Hoitt’s Furniture building on Wilson Street, is focused on one at-risk population: women, and mothers with children. It will provide treatment for an estimated 400 women annually, said Dick Anagnost, a businessman who is chairman of the Families in Transition board of directors. (Tuohy, 2/22)

Boston Globe:
‘Angel’ Opioid Initiative Thrives Despite Exit Of Gloucester Police Chief
As Gloucester police chief, Leonard Campanello pledged in 2015 that drug users could walk into the police station, hand over heroin, and walk out into treatment within hours — without arrest or charges. The concept of help rather than handcuffs became a national sensation. But when Campanello left office in October, under fire for allegedly lying to city investigators probing complaints by two women against him, questions arose about the future of a program propelled in part by Campanello’s outsize personality. (MacQuarrie, 2/21)

Georgia Health News:
House Health Panel Approves Needle Exchange Bill
House Bill 161 is sponsored by state Rep. Betty Price, a physician. She is the wife of U.S. Health and Human Services Secretary Tom Price, who is also a physician and was until recently a U.S. congressman from Georgia. She backed a similar proposal last year. It was approved by the House but failed to get consideration in the state Senate. (Miller, 2/21)

The Associated Press:
Lawmakers Urge VA To Explain Rising Cases Of Drug Theft
The heads of two congressional committees said Tuesday they want the Department of Veterans Affairs to better explain its efforts to stem drug theft and loss in light of rising cases of missing prescriptions and other unauthorized use at VA hospitals. Rep. Phil Roe, who chairs the House Veterans Affairs Committee, said his panel had scheduled a hearing for Monday. The Associated Press reported last Monday on government data showing a sharp increase since 2009 in opioid theft and drugs that had simply disappeared at the VA. (Yen , 2/21)

It is also the only high-income country without universal health insurance coverage and has the largest share of unmet health-care needs due to financial costs. In other public health news: vaccines, heart disease, testosterone, art therapy and post-election stress.

The Washington Post:
U.S. Life Expectancy Will Soon Be On Par With Mexico’s And The Czech Republic’s
Life expectancy at birth will continue to climb substantially for residents of industrialized nations — but not in the United States, where minimal gains will soon put life spans on par with those in Mexico and the Czech Republic, according to an extensive analysis released Tuesday. South Korean women and Hungarian men are projected to make the largest overall gains (with South Koreans second among males). There is a better-than-even chance that South Korean women will live to an average of 90 years old by 2030, which would be the first time a population will break the 90-year barrier, according to the research published in The Lancet. (Bernstein, 2/21)

Roll Call:
One Thing Congress Agrees On: Vaccines Work
A bipartisan group of lawmakers are stressing the need to highlight benefits of vaccines amid reports of local outbreaks of infectious diseases. “The science is clear: FDA-licensed vaccines are proven to be safe and effective, and save the lives both of those who receive them and vulnerable individuals around them,” the lawmakers wrote in a Tuesday letter sent to their colleagues. “As Members of Congress, we have a critical role to play in supporting the availability and use of vaccines to protect Americans from deadly diseases.” (Bowman, 2/21)

Miami Herald:
Don't Ignore Shortness Of Breath, Lightheadness
The Centers for Disease Control and Prevention estimates that anywhere from 2.7 to 6.1 million Americans suffer from atrial fibrillation and reports that more than 750,000 related hospitalizations occur annually. With 130,000 estimated deaths each year — a rate that has been rising for more than two decades — atrial fibrillation costs the United States about $6 billion each year, according to the CDC. [David] Ancona, who says that patients with superventricular tachycardia appear in the ER daily, believes prevention is key. But the nature of the disease can make that difficult. (Ogle, 2/22)

Miami Herald:
Carrie Fisher’s Death Sheds New Light On Women’s Heart Disease
For years, the National Institutes of Health, which provides most of the money for medical research, has used male mice to study heart disease. Why? Men were the primary research subjects. Women have heart disease, too. In fact, heart disease is the No. 1 killer of American women (and men). Yet heart disease death rates in the United States have declined steadily for men over the last quarter century. Not so much for women. (Cohen, 2/21)

NPR:
Testosterone Has Mixed Results On Older Men's Health
Many men over 65 with low testosterone levels say their sense of well-being, not to mention sexual function, isn't what it used to be. That's why some doctors prescribe testosterone replacement. But the effectiveness of testosterone has been controversial. Studies of the risks and benefits have been mixed, and the Food and Drug Administration beefed up its warnings about cardiac side effects of testosterone supplementation in 2015. (Neighmond, 2/21)

NPR:
Testosterone Patients Not Told About Anemia
There's a lesson about one of the testosterone studies released this week that has nothing to do with testosterone: The study on how testosterone affects anemia was designed with an ethical lapse that nobody noticed until the study was complete. That's surprising because it was designed and carried out by a couple of dozen of well-regarded scientists. Their protocols were reviewed by 12 university institutional review boards, whose job is to evaluate the ethics of an experiment. It was funded by the National Institutes of Health, and the trial was overseen by a watchdog data safety and monitoring board. But all of those safety features fell short this time. (Harris, 2/21)

The Wall Street Journal:
Karen Pence’s Advocacy For Art Therapy Stirs Controversy
As Vice President Mike Pence visited Europe to reassure world leaders, his wife, Karen Pence, pursued her own issue: promoting art therapy. At first blush, it might seem Mrs. Pence’s support for art therapy would win public backing akin to the broad support Barbara and Laura Bush received for their promotion of literacy, instead of the divisive type of response Tipper Gore got for her campaign against offensive music lyrics. But the Donald Trump era is no ordinary time. (Barnes, 2/21)

Kaiser Health News:
A New Diagnosis: ‘Post-Election Stress Disorder’
Wally Pfingsten has always been a news junkie. But since President Donald Trump was elected, he’s been so anxious about the political tumult that even just having the TV news on in the background at home is unbearable. “It’s been crippling,” said the 35-year-old San Mateo, Calif., resident and political moderate who has supported both Democratic and Republican candidates in the past. “I feel angry, really, really angry, far more angry than I expected to be. (Gold, 2/22)

New Hampshire Union Leader:
DHHS Budget Calls For $10M In Raises For Nurses
A 15 percent raise for nurses working in the Department of Health and Human Services will cost the state $10 million over the next two years, but is necessary to attract and retain health care professionals in an increasingly competitive market, according to Health and Human Services Commissioner Jeffrey Meyers. The head of the state’s biggest agency presented a $1.4 billion two-year spending plan for fiscal years 2018-2019 to House budget-writers on Tuesday. He said increased pay for nurses and other providers is a top priority. (Solomon, 2/21)

Austin Statesman:
Legislator Seeks To Keep Guns Out Of State Psychiatric Hospitals
One year after state psychiatric hospitals began letting people carry guns on campus, a Republican legislator is pushing a bill that reverses course. House Bill 14, filed by Rep. Andrew Murr, R-Junction, outlaws firearms at Texas’ 10 state-run mental health hospitals, which care for people with depression, schizophrenia, bipolar disorder and other illnesses. (Ball, 2/21)

Health News Florida:
Flu Widespread In Florida, With Extra Bug
Influenza season is at its peak nationwide, and Florida is no exception. That's obvious on the map at the Centers for Disease Control website. Warren McDougle, epidemiology manager for the Hillsborough County Health Department, says the flu shot apparently did a good job of covering the predominant strain, A (H3). But unfortunately, there's another mean virus going around, according to anecdotal reports. (Gentry, 2/21)

Register-Guard:
Oregon Plan Would Provide Insurance To Unauthorized Kids
Now, both women are advocating for a new state law — dubbed "Cover All Kids" by supporters — that would extend government-funded health insurance in Oregon to many unauthorized immigrants under the age of 19. The proposal would give government-funded health insurance to an estimated 17,600 unauthorized immigrants, at a cost of $55 million in the biennium that starts July 1. Critics blast the concept and the price tag, especially given state government's cash crisis.But supporters say it's a humane and sensible idea. (Hubbard, 2/21)

The Wall Street Journal:
Bidder Says Los Angeles-Area Hospital Didn’t Need To Close
A health-care firm that offered to buy Gardens Regional Hospital and Medical Center Inc., a Los Angeles-area hospital that cared for low-income residents before shutting down, told a bankruptcy judge that its purchase efforts were unfairly ignored. In court papers, Le Summit Healthcare LLC officials told Bankruptcy Judge Ernest Robles that they are still willing to operate the nonprofit hospital while they obtain the new licensing and permits to restart its operations. They say Gardens Regional Hospital’s lawyers closed the 137-bed hospital unnecessarily. (Stech, 2/21)

St. Louis Public Radio:
Homer G. Phillips Hospital: ‘They Were Not Going To Be Treated As Second-Class Citizens’
In the first half of the 20th century, segregation touched virtually every part of American life. Black residents of St. Louis weren't just barred from schools, lunch counters and drinking fountains reserved for whites. Even hospitals could refuse to admit black patients. But the hospitals that were built to serve African-American patients hold a special place in medical history. The facilities employed and trained thousands of black doctors and nurses. In St. Louis, Homer G. Phillips Hospital quickly became a trusted household name. Today marks the 80th anniversary of its dedication ceremony on Feb. 22, 1937. (Bouscaren, 2/22)

The Star Tribune:
Minnesota Medical Professionals Work To Close Health Gaps For LGBT Patients
[Deb] Thorp, medical director of the Park Nicollet Gender Services Clinic in Minneapolis, is taking part in a rare national conference next week to address health disparities among lesbian, gay, bisexual and transgender people. She and other researchers say the LGBT community is more vulnerable to some diseases, and has poorer access to, and a lower quality of, health care compared with the general population — in part because of fear. (Shah, 2/21)

The Star Tribune:
Minnesota Parents Lobby For Kids At 'Dyslexia Day' At State Capitol
On Tuesday, the advocacy group’s annual rally spread across the Capitol rotunda, where several hundred parents and children called attention to a hidden disability that affects as many as one in 10 children. Dyslexia wasn’t even recognized as a specific learning disability by the Minnesota Department of Education until 2015. Children who spoke at Tuesday’s rally said they wished schools understood more. (Hopfensperger, 2/21)

St. Louis Public Radio:
Chemical Companies To Pay $15 Million To Clean Up Sauget Superfund Site
Four chemical companies could have to pay $14.8 million to clean up a federal Superfund site in Sauget. The settlement, which needs court approval, would address groundwater contamination, cap some of the waste and install a well monitoring system. Industrial waste has been dumped in six sites within the Sauget Area 1 Superfund from the 1930s until the 1980s. The Environmental Protection Agency has been investigating the site since the early 1980s. (Chen, 2/21)

Sacramento Bee:
Orphan Drugs Offer Hope For Treating Rare Diseases, Despite High Price Tags
At Sutter Children’s Center in Sacramento this week, the 7-year-old was given an injection of Spinraza, the first drug approved in the U.S. to treat spinal muscular atrophy, or SMA. ... With Spinraza, each thumb-sized 5-milliliter vial – about a teaspoon’s worth – costs $125,000. The recommended dosage is four “loading” injections within about two months, followed by maintenance shots every four months for life. For families such as the Goepperts, that price tag is staggering: roughly half a million dollars just for the initial series of Spinraza shots and $375,000 a year thereafter. (Buck, 2/20)

USA Today:
New Patient Group Focuses On Drug Prices Amid Bipartisan Concern
A new patient advocacy group launches Wednesday that distinguishes itself by focusing only on drug prices and eschewing money from the pharmaceutical industry at a time when drug makers are pouring millions into a campaign fighting efforts to regulate them. The formation of Patients for Affordable Drugs (PFAD) comes as local officials and members of Congress are decrying the latest huge drug price hikes, this time by drugmaker Kaléo for its version of the overdose antidote naloxone. (O'Donnell and Shesgreen, 2/22)

Stat:
The Latest Voucher Deal Suggests Prices Are Finally Falling
In a noteworthy deal, Gilead Sciences agreed to pay $125 million to Sarepta Therapeutics for a priority review voucher. But one Wall Street analyst expressed disappointment over the price tag and suggested the deal raises questions about how much these controversial vouchers can fetch going forward. (Silverman, 2/21)

San Francisco Chronicle:
Pharma CEO Insists $89,000 Drug Will Be Affordable For Patients
When Marathon Pharmaceuticals’ $89,000 price for a year’s supply of its newly approved muscular dystrophy drug sparked outrage this month, the company’s CEO responded with another figure: $20. That’s how much he expects Duchenne muscular dystrophy patients to pay per prescription of the drug, he wrote in a letter posted on the company’s website. Insurers would cover the medication, and patients would pay only their typical co-pays. He touted the company’s patient assistance program to help patients defray out-of-pocket costs. (Schencker, 2/21)

Stat:
Q&A: Pharmacy Middlemen Are 'Monopolistic Terrorists'
Recent debates about drug pricing have tended to focus on manufacturers and patients, but Doug Collins is among the few legislators looking at the middlemen. Collins, a Republican congressman from Georgia, railed against the country’s three major pharmacy benefit managers in an interview with STAT, expressing his desire for a drug-pricing debate that centers on what he views as the true power centers instead of “Pharma bro” and the push to allow drug-price negotiation under Medicare Part D. (Facher, 2/20)

Boston Globe:
Harvard Pilgrim Expands Use Of Novel Drug Purchasing Deals
Leveraging its buying power as one of the state’s largest health insurers, Harvard Pilgrim Health Care has struck two more deals to pay for expensive drugs based on how effectively they treat patients, an emerging strategy aimed at reining in medical spending. Harvard Pilgrim, which has 1.3 million members, said the agreements cover the rheumatoid arthritis medicine Enbrel, made by Amgen Inc., and Eli Lilly & Co.’s osteoporosis medicine Forteo. (McCluskey and Woodward, 2/22)

Stat:
Here's Why J&J Won The Bidding For Actelion – And Sanofi Didn't
As big-game hunting goes, Sanofi chief executive Olivier Brandicourt is 0-for-2. Two months ago, Sanofi appeared to be on the verge of acquiring Actelion Pharmaceuticals, which would have been a notable accomplishment for a couple of reasons: Johnson & Johnson had just backed out of negotiations to acquire Actelion and Sanofi had recently lost out on bidding for Medivation, a stinging defeat in a growth strategy that relies on big deals. (Silverman, 2/16)

Stat:
PhRMA CEO: 'FDA Review Process Is The Gold Standard'
The CEO of the Pharmaceutical Research and Manufacturers of America on Tuesday came out strongly in favor of a rigorous Food and Drug Administration. His remarks come as the Trump administration weighs potential candidates to lead the agency who have suggested they would radically change how it vets new drugs. Asked by STAT about the notion that the FDA should no longer evaluate drugs for effectiveness, the industry trade group’s Stephen Ubl was unambiguous: “We believe that the FDA review process is the gold standard and should remain so.” (Robbins, 2/21)

LancasterOnline:
Pennsylvania Proposal Would Make Prescription Drug Manufacturers Reveal Costs
Some state lawmakers are proposing to give the Insurance Department more teeth to tackle the problem of skyrocketing prescription drug prices. House Bill 161 would require pharmaceutical companies to disclose the cost of drugs — including materials, research, clinical trials, marketing and advertising.The bill is co-sponsored by Lancaster city Democrat Mike Sturla and Jim Cox, a Republican who represents part of northern Lancaster County. (Stauffer, 2/21)

Los Angeles Times:
Big Pharma Really, Really Doesn't Want You To Know The True Value Of Its Drugs
The latest poster child for cruel and inhuman drug pricing is Kaleo Pharma, maker of an emergency injector for a med called naloxone, which is used as an antidote to save the lives of people who overdose on painkillers. As America’s opioid crisis reaches epidemic levels, Kaleo has jacked up the list price for its Evzio auto-injector by 600%, soaring from $690 several years ago to $4,500, according to lawmakers. (David Lazarus, 2/17)

The Wall Street Journal:
How Other Countries Freeload On U.S. Drug Research
President Trump says American companies have been getting “systematically ripped off” by foreign governments and firms. He’s right. Yet he has backed a proposal that would make the problem even worse—permitting Americans to buy prescription drugs from overseas retailers, a practice known as importation. This policy wouldn’t help American consumers much, but it would gut American pharmaceutical companies. The negotiator-in-chief should instead use his skills to open foreign markets for American firms. (Peter Pitts, 2/21)

The Hill:
Allowing Medicare To Directly Negotiate Drug Prices Will Hurt Seniors’ Access To New Drugs
President Trump's recent attack on pharmaceutical companies as "getting away with murder" is the stuff of headlines. He also commented that the federal Medicare program could save billions of dollars if the program negotiated prices directly with pharmaceutical companies. But lawmakers and the public should understand what direct Medicare drug price negotiations might mean for seniors' access to needed treatments. (Rafael Fonseca, 2/17)

National Review:
Donald Trump & Prescription Drug Costs: Harder To Lower Than They Seem
Keeping track of Donald Trump’s shifting policy positions could make even the most balanced of observers dizzy. Take, for example, the president’s position on prescription-drug prices. Candidate Trump garnered bipartisan plaudits by criticizing the pharmaceutical industry for the high cost of prescription drugs. Shortly after becoming president, he reached out to Democrats such as Representative Elijah Cummings with a promise to lower drug costs. But not long after that, he met with drug company CEOs and backed away from that promise. (Michael Tanner, 2/15)

Health Affairs:
Can Employers Take A Bigger Role In Controlling Drug Costs?
An estimated 150 million Americans receive insurance through their employer — and employees and employers alike continue to suffer from “sticker shock” for prices for new drugs, despite several years of debate and threatened congressional action to control the high prices of pharmaceutical products. While considerable attention has been paid to potential actions by Medicare or the Food and Drug Administration (FDA), there has been less focus on the role of private payers to solve the issue. Employers sponsoring health benefits are not bound by the same statutory constraints that apply to Medicare and can decide with fewer restrictions what is covered and how much of the cost employees pay for each service. However, employers are sensitive to making changes to health benefits that could interfere with employee recruitment and this article will discuss employers’ options to address high drug prices more aggressively in that context. (Rober Galvin and Troyen Brennan, 2/17)

Albany Times Union:
Why We Get Frustrated With Prescription Drug Prices!
This weekend as I was thumbing through some items in the pharmacy, I came across the manufacturers information on the reintroduction of Auvi-Q to the market. Auvi-Q is a autoinjector of epinephrine which is more publicly known as Epi-Pen. The drug is made by Kaleo who you might remember as they recently made news with their new product for narcan for drug overdose know as Evzio. Evzio as was noted in this interview by Asa Stackel at WNYT 13, comes in at a price of $4,920 per unit which significantly more expensive than other naloxone products which are in the $100 range on average. As a reminder the Evzio was about $690, came off the market and then back on at $4,920. Well history is repeating itself…..Auvi-Q, which last time we dispensed it was about $465 in early 2016 is back on the market at $4,200. Yes, a ten fold increase! (New York Assemblyman John T. McDonald, 2/20)

Bloomberg:
Alexion Needs New Bets
Alexion Pharmaceuticals Inc. is the latest in a long line of biopharma dealmakers to wish for a time machine. Its $8.4 billion acquisition of Synageva in 2015 was meant to help resolve its dependence on its leading rare-disease drug Soliris. It's not working. (Max Nisen, 2/16)

The Motley Fool:
Thanks, Martin Shkreli, For The Dumbest Advice Ever On Drug Pricing
Martin Shkreli is the epitome of everything the American consumer loves to hate. Shkreli, formerly the CEO of privately held Turing Pharmaceuticals, found himself in the spotlight in Sept. 2015 after his company acquired the rights to Daraprim, a life-saving, infection-fighting drug for AIDS and cancer patients. Despite not changing the formulation of Daraprim (which happened to be more than six decades old), or altering its manufacturing process one iota, Shkreli raised its per-pill price from $13.50 to $750 overnight, a nearly 5,500% increase. (Sean Williams, 2/17)

Chicago Tribune:
To The GOP On Obamacare: This Spud's For You
Health care policy as a political hot potato has become a popular metaphor. Writers at Vox, CNBC, the American Constitution Society and elsewhere have compared Obamacare to a fresh-from-the-oven tuber that's too painful to hold and must be tossed back across the aisle as quickly as possible. Noting growing concerns about inherent flaws in the complex structure of Obamacare — formally known as the Patient Protection and Affordable Care Act — libertarian Bloomberg View columnist Megan McArdle argued in a Feb. 15 essay that Congress is no longer "arguing about whether (and how) the exchanges can be saved, but playing hot potato as both parties vie to avoid being stuck with the blame for the ensuing disaster." Nice try. (Eric Zorn, 2/21)

Roll Call:
Town Hall Winners And Losers So Far
We’re halfway through the Presidents Day recess, the first during President Donald Trump’s first term in office. ... it’s no surprise that town halls would become a focal point for the anger swirling on the left. Some members have plainly refused to meet with groups they think will be hostile to them. Others have flung open the sashes and let the emotions fly. Others have worked assiduously to restrain something that is inherently not theirs to control — the reaction of voters to their government’s actions in Washington. With half of the recess still left to play out, here are the winners and losers so far. (Patricia Murphy, 2/22)

The Wall Street Journal:
Repeal And Replace Panic
In the 2009 ObamaCare debate, White House aide David Plouffe told nervous Democrats “no bed-wetting,” meaning keep calm and all will be well. House Democrats went on lose 63 seats in 2010, but the double irony is that Mr. Plouffe’s advice now applies to those reporters and liberals who seem to be invested in the failure of the GOP’s version of health-care reform. Every day brings a new story about Republicans in disarray, the “mirage” of the GOP’s reform and the impossibility of change. ... The reality is that Congress is on schedule, progress is underway, and the many potential problems are avoidable. (2/21)

Forbes:
Cassidy-Collins Patient Freedom Act Looks Better As Other Reform Efforts Falter
In a different political climate, the "Patient Freedom Act" introduced last month by Republican Senators Bill Cassidy and Susan Collins would be getting close scrutiny and perhaps some significant support. It is -- and I apologize for language that appears to have become profane in these polarized times -- a compromise. The bill recognizes that an outright repeal and replacement of Obamacare is going to be politically challenging for at least the next two years. It likewise recognizes that the persistence of Obamacare nationwide is likely to be challenging and expensive. (Seth Chandler, 2/21)

Bloomberg:
A GOP Tax Idea Would Upend Health Insurance
Last week brought thwarted mergers, threats by insurers to leave the Affordable Care Act's individual exchanges, and the release of a (very) rough sketch of a possible GOP repeal-and-replace plan for the ACA. What's missing in that skeletal outline is how to pay for new initiatives, such as an expanded tax credit to help people buy insurance, while also repealing the new taxes established by the ACA. Some in the GOP are floating one possible solution: capping the federal tax breaks workers and companies get for employer-provided health insurance. (Max Nisen, 2/21)

WBUR:
Caring For Immigrant Patients When The Rules Can Shift Any Time
Knowing patients’ immigration status and the reasons they came to this country can affect the services they are eligible for, the relative costs of medications, the fears that may keep them from returning for needed services, and even the diagnosis of unexplained symptoms. Immigration policy, Marlin told us, "is no longer a spectator sport" for us or for our patients. But it is not simple to practice medicine under these new and uncertain circumstances. (Elisabeth Poorman, 2/21)

Bloomberg:
'Right To Try' Laws Don't Help The Dying
A national “right to try” law, supported by Vice President Mike Pence and scores of Republicans in the the House and Senate, is meant to circumvent the FDA’s regulatory authority by giving patients who are terminally ill the right to use drugs that the agency hasn’t yet approved. The idea sounds reasonable; in the past few years, bipartisan majorities in two-thirds of state legislatures have passed essentially the same law. In reality, however, these laws give patients no new rights at all. They do nothing to compel drug makers to provide experimental medicines to the dying, or insurers to pay for them. They merely eliminate a patient’s right to sue for any injuries that might arise -- that is, if any patient ever gets an untested drug in this way. (2/21)

Boston Globe:
Did Dana-Farber Pay Too High A Price For Its Mar-A-Lago Fund-Raiser?
When asked why he robbed banks, the legendary bank robber Willie Sutton said, “Because that’s where the money is.” That’s also why the Dana-Farber Cancer Institute holds fund-raisers at Mar-a-Lago, the posh Palm Beach resort that serves as President Trump’s Florida home. It’s where the money is. The most recent gala, held over the past weekend, raised $2.2 million. All for a good cause. But at what cost? (Joan Vennochi, 2/21)

St. Louis Post-Dispatch:
Turn Off The Drug Spigot In The St. Louis Region
Heroin and opioid overdoses have increased to the point where they claim more lives regionally than homicides. State and local lawmakers need to focus greater efforts on combating a growing epidemic. Gov. Eric Greitens’ pledge to help create a statewide prescription drug database is a good start, but a more comprehensive law enforcement effort would go even further to push down the number of drug-related deaths. (2/21)

Pittsburgh Post-Gazette:
Overprescribed: Curbing The Easy Fix Of Psychiatric Meds For Seniors
With many communities still struggling to manage the opioid epidemic, the last thing the nation needs is a new drug-related problem — the overprescribing of psychiatric and other medications to senior citizens. A new report in the journal JAMA Internal Medicine raises a red flag about the trend, saying it appears to be particularly common in rural areas where patients with symptoms of mental illnesses might have less access to talk therapy and other nondrug treatments. But even in these communities, there are alternatives to medications that can and should be explored. (2/20)

Stat:
Patient Reviews Published Online Can Help Improve Health Care
It’s no secret that the US health care system needs to improve. Consumers — in this case patients and employers — have more collective power to influence change than they realize by choosing how, where, and from whom they get health care. Uber, Nordstrom, and many other companies seek their customers’ opinions and respond to them. Health care needs to follow suit to become the patient-centered service industry that it should be. The University of Utah, where I work, began collecting patient feedback early on and was the first health system in the US to publicly post patients’ reviews of their providers. It has paid off in many ways. (Vivian S. Lee, 2/21)